Week 3 - Chapter 4 - Psychoanalytic Therapy

"blank-screen" approach

Analysts typically assumes an anonymous, non-judgemental stance

Superego

the part of personality that represents internalised ideals and provides standards for judgment (the conscience) and for future aspirations; related to psychological rewards and punishments; strives for perfection

object-relations theory

the psychodynamic theory that views the desire for relationships as the key motivating force in human behavior

manifest content of dreams

the surface, "visible" content of a dream; dream images as they are remembered by the dreamer; process of turning latent to manifest = DREAM WORK

Crisis (Erikson)

the turning point faced at each developmental stage; potential to move forward or to regress

psychodynamic therapy

therapy deriving from the psychoanalytic tradition (shortened and simplified) that views individuals as responding to unconscious forces and childhood experiences, and that seeks to enhance self-insight

contemporary psychoanalysis

Newer formulations of psychoanalytic theory that share some core characteristics of classical analytic theory, but with different applications of techniques; extensions and adaptations of orthodox psychoanalysis; tends to be based on ego psychology

moral anxiety (freud)

the fear of one's own conscience; when the ego cannot control anxiety by rational and direct methods, it relies on indirect ones— namely, ego-defense behavior.

neurotic anxiety (freud)

the fear that the instincts will get out of hand and cause the person to do something for which she or he will be punished

reality principle (ego)

the governing principle of the ego, which involves considerations of social acceptability and practicality; intelligence and rationality

Pleasure Principle (Id)

the governing principle of the id, involving demands for immediate gratification of needs; illogical, amoral, has drive to satisfy needs

individuation (Jung)

the harmonious integration of the conscious and unconscious aspects of personality (an innate and primary goal)

Phallic (3-6 years)

the inability to fully accept one's sexuality and sexual feelings, and also to difficulty in accepting oneself as a man or woman

why should termination be set in advance?

termination tends to bring up intense feelings of attachment, separation, and loss

Resistance

the blocking from consciousness of anxiety-laden material; anything that works against the progress of therapy and prevents the client from producing previously unconscious material

psychosexual stages

the childhood stages of development (oral, anal, phallic, latency, genital) during which the id's pleasure-seeking energies focus on distinct erogenous zones

collective unconscious (Jung)

the deepest and least accessible level of the psyche; inherited experiences of human and prehuman species

Libido (Freud)

(psychoanalysis) a Freudian term for sexual urge or desire

Psychoanalytic therapy that has Freud's psychosexual view + Erikson's psychosocial view, ask questions like:

- What are some major developmental tasks at each stage in life, and how are these tasks related to counseling? - What themes give continuity to this individual's life? - What are some universal concerns of people at various points in life? How can people be challenged to make life-affirming choices at these points? - What is the relationship between an individual's current problems and significant events from earlier years? - What choices were made at critical periods, and how did the person deal with these various crises? - What are the sociocultural factors influencing development that need to be understood if therapy is to be comprehensive?

death instincts (Freud)

- aka Thanatos - unconscious human desire to return to the inanimate state - expressed in destructive aggressive behavior, including the self-aggression and suicidal tendencies

countertransference in group therapy

- be alert to signs of unresolved internal conflicts that could interfere with effective group functioning and create a situation in which members are used to satisfy the leaders' own unfulfilled needs - don't turn it into a group w conforming, dominant cultural values (if you are afraid of losing your own worldview in a group setting as a leader)

What counts as the unconscious?

- dreams - slips of the tongue, forgetting a familiar name - posthypnotic suggestions - results of the application of free-association techniques - results of the application of projective techniques - symbolic content of psychotic symptoms

psychoanalytic therapist's goals

- establish therapeutic alliance, and repairing any damaged alliance is essential if therapy is to progress - pay attention to client's resistances - listen in a respectful, open-minded way - decide when to make appropriate interpretations; tact and timing - to accelerate the process of uncovering unconscious material

psychoanalytic therapist's functions

- help clients acquire the freedom to love, work, and play - assisting clients in achieving self awareness, honesty, and more effective personal relationships - in dealing with anxiety in a realistic way - in gaining control over impulsive and irrational behavior

Psychoanalytic treatment goals are

- increase adaptive functioning - reduction of symptoms - resolution of conflicts

client's experience in psychoanalytic therapy

- lie on couch -> encourages deep, uncensored reflections, reduces stimuli that might interfere, reduces ability of client to read the facial expressions of the therapist (fosters projections characteristic of transference) - unique relationship w therapist (nonjudgmental -> encourages the client to loosen defense mechanisms and "regress," allows for positive therapeutic growth but also involves some vulnerability

six basic techniques of psychoanalytic therapy

- maintaining the analytic framework - free association - interpretation - dream analysis - analysis of resistance - analysis of transference

Freudian psychoanalytic therapy goals

- make the unconscious conscious - strengthen the ego so that behavior is based more on reality and less on instinctual cravings or irrational guilt - success = significant modification of the individual's personality and character structure

purposes of dreams (Jung)

- prospective; they help people prepare themselves for the experiences and events they anticipate in the near future - compensatory function; for the overdevelopment of one facet of the individual's personality more as an attempt to express than as an attempt to repress and disguise.

Optimal Criteria for termination of therapy

- reduction of transference - accomplishing main goals of therapy - acceptance of the futility of certain strivings and childhood fantasies - increased capacity for love and work - achieving a more stable coping pattern - self-analytic capacity developed

psychodynamic model in group counselling

- transference and countertransference will have implications for practice of group therapy; symbolic mothers, fathers, lovers, siblings etc - can help clients gain awareness of why they are projecting these feelings towards one another - provides dynamic understanding of how people function in out-of-group situations.

Freud views on why people have problems

- unresolved issues in the past - lack of self-awareness - conflicts in the unconsciousness

Erikson's stages of psychosocial development

1. INFANCY: trust vs. mistrust 2.EARLY CHILDHOOD: autonomy vs. shame and doubt 3. PRESCHOOL AGE: initiative vs. guilt 4. SCHOOL AGE: industry vs. inferiority 5. ADOLESCENCE: identity vs. role confusion 6. YOUNG ADULTHOOD: intimacy vs. isolation 7. MIDDLE AGE: generativity vs. stagnation 8. LATER LIFE: integrity vs. despair

5 stages of therapy

1. Rapport 2. Data gathering 3. Goal setting 4. Working/intervention 5. Homework and evaluation

dream analysis

A psychoanalytic technique in which the therapist interprets the symbolic meaning of the client's dreams; defenses are lowered and repressed feelings surface. two levels - latent and manifest content

Freudian View of Human Nature

INSTINCTS; behavior is determined by irrational forces, unconscious motivations, and biological and instinctual drives as these evolve through key psychosexual stages in the first six years of life

life instincts (Freud)

Instincts that are oriented toward growth, development, and creativity; goal of life was gaining pleasure and avoiding death

Id

all the untamed drives or impulses that might be likened to the biological component; primary source of psychic energy

Transference

Reacting to another as if the person is someone from the past Goal: Understand feelings/thoughts; remove distorted reality; the therapist becomes a current substitute for significant others

types of ego-defense mechanisms

Repression Denial Reaction formation Projection Displacement Rationalisation Sublimation Regression Introjection Identification Compensation

latent content of dreams

The hidden or symbolic meaning of a dream, as revealed by dream interpretation and analysis

Classical psychoanalysis

The traditional (Freudian) approach to psychoanalysis based on a long-term exploration of past conflicts, many of which are unconscious, and an extensive process of working through early wounds; grounded on id psychology

transference relationship

The transfer of feelings originally experienced in an early relationship to other important people in a person's present environment; eg whatever the client feels toward them will largely be the product of feelings associated with other significant figures from the past bc therapist shares nothing personal

Countertransference

Therapist has transference reaction to the patient; own conflicts are triggered -> resulting in a distorted perception of the client's behavior BUT can also be positive -> can have insight into client's world eg if you get annoyed at client all the time, you might discover it's bc client is always demanding

Limitations of classical analysis

This approach may not be appropriate for all cultures or socioeconomic groups. Deterministic focus does not emphasize current maladaptive behaviors. Minimizes role of the environment. Requires subjective interpretation. (power differential -> client may rely on therapist a lot) Relies heavily on client fantasy. Lengthy treatment may not be practical or affordable for many clients.

Anxiety

a feeling of dread that results from repressed feelings, memories, desires, and experiences that emerge to the surface of awareness; develops out of a CONFLICT among id, ego, superego (over control of available psychic energy)

ego psychology

a school of psychodynamic thought that emphasizes the skills and adaptive capacities of the ego; these therapists assist clients in gaining awareness of their defenses, help them develop better ways of coping

Ego-defense mechanisms

according to psychoanalytic theory, strategies developed by the ego to control unacceptable id impulses and to avoid or reduce the anxiety they arouse - they deny/distort reality - they operate on an unconscious level

Ego

actions of ego may/may not be conscious, "executive" part of personality that mediates among the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id's desires in ways that will realistically bring pleasure rather than pain.

Reaction formation

actively expressing the opposite impulse when confronted with a threatening impulse; eg being nice to people you hate; then you don't have to face anxiety that would result if you recognise these dimensions of yourself

interpretation

analyst's pointing out, explaining, and even teaching the client the meanings of behavior that is manifested in dreams, free association, resistances, defenses, and the therapeutic relationship itself; HAS to be appropriately timed because the client will reject therapist interpretations that are poorly timed

Projection

attributing to others one's own unacceptable desires and impulses; self-decption - "those people are bad, but not me"

relational model

based on the assumption that therapy is an interactive process between client and therapist; exploration of the complex conscious and unconscious dynamics at play with respect to both therapist and client

psychosocial stages (Erikson, 1963)

basic psychological and social tasks, which individuals need to master at intervals from infancy through old age

Animus/anima (jung)

both the biological and psychological aspects of masculinity and femininity, which are thought to coexist in both sexes

Freud's psychosexual view + Erikson's psychosocial view =

counselors have a helpful conceptual framework for understanding developmental issues as they appear in therapy

Anal Stage (18-36 months)

deals with the inability to recognize and express anger, leading to the denial of one's own power as a person and the lack of a sense of autonomy

Displacement

directing energy toward another object or person when the original object or person is inaccessible; eg instead of facing an intimidating boss, you come home and shout at your kids

Sublimation

diverting sexual or aggressive energy into other channels; eg doing sports

Jung's analytical psychology

elaborate explanation of human nature that combines ideas from history, mythology, anthropology, and religion

Freudian Perspective - human are viewed as

energy systems; psychic energies are distributed to id, ego and superego. energy limited -> therefore one system gains control over the available energy at the expense of the other two systems -> behaviour is determined

relationship between contemporary relational psychoanalytic therapist and client

focuses on here-and-now transference as on earlier reenactment; view their emotional communication with clients as a useful way to gain information and create connection

relationship between classical therapist and client

has an objective stance; stands outside of rs, comments on it and offers insight-producing interpretations

reality anxiety (freud)

he fear of danger from the external world, and the level of such anxiety is proportionate to the degree of real threat

Self Psychology (Kohut)

how we use interpersonal relationships (self objects) to develop our own sense of self; nonjudgmental acceptance, empathy, and authenticity

Freud's Structure of Personality

id, ego, superego; one's personality functions as a whole rather than as three discrete segments

Identification

identifying with successful causes, organisations, or people in the hope that you will be perceived as worthwhile; enhance self-worth; either a developmental phase, or a defensive reaction for ppl who feel inferior

Archetypes (Jung)

images of universal experiences contained in the collective unconscious - persona - animus/anima - shadow

free association

in psychoanalysis, a method of exploring the unconscious in which the person relaxes and says whatever comes to mind, no matter how trivial or embarrassing; eg Roscharch Inkblot test

Oral Stage (0-18 months)

inability to trust oneself and others, resulting in the fear of loving and forming close relationships and low self-esteem

Introjection

integrating the beliefs and values of another individual into one's own ego structure; like incorporating parental values; OR prisoners accepting values of the aggressor (by identifying w them)

Rationalisation

making up a socially acceptable explanation to justify unacceptable thoughts, feelings or behaviour; avoid a bruised ego. eg "i never wanted that job anyway"

Persona (Jung)

mask, or public face, that we wear to protect ourselves

Compensation

masking perceived weaknesses or developing certain positive traits to make up for limitations eg "only look at my accomplishments pls"

Shadow (Jung)

most dangerous and powerful of the archetypes; represents our dark side, the thoughts, feelings, and actions that we tend to disown by projecting them outward

Repression

painful thoughts/feelings excluded from awareness involuntarily; these painful events do influence later behaviour

When there is resistance in clients, therapists should

point out and interpret the most obvious resistances to lessen the possibility of clients' rejecting the interpretation and to increase the chance that they will begin to look at their resistive behavior; need to respect it as well

Three kinds of anxiety

reality, neurotic, moral

Denial

refusing to believe or even perceive painful realities; generally operates at preconscious/conscious levels

Regression

return to an earlier or less advanced condition, where there were fewer demands; frightened to the point where you start wetting your bed at 15 years old

maintaining the analytic framework; how?

this works bc consistency = therapeutic factor -> like feeding a baby regularly - analyst's relative anonymity (no personal info) - maintaining neutrality and objectivity - regularity and consistency of meetings - starting and ending the sessions on time - clarity on fees basic boundary issues

aim of psychoanalytic therapy

to make the unconscious motives conscious, for only then can an individual exercise choice; work through transference distortions